Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 18216 | FL |
NPI | 1154638120 |
---|---|
Provider Name | Mrs. Emma Vega Garriga |
First Address | Miami, FL 33165-6244 |
Second Address | Miami, FL 33165-6244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2010 |
Last Update Date | 11/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
887947800 | (05) | FL |